Newborn Warning Signs

What warning signs may mean a problem with a newborn?

Your newborn baby is going through many changes in getting used to life in the outside world. This adjustment almost always goes well. But there are certain warning signs you should watch for with newborns. These include:

Not urinating (this may be hard to tell, especially with disposable diapers)

No bowel movement for 48 hours

Fever (see Fever and children, below)

Breathing fast (for example, over 60 breaths per minute) or a bluish skin coloring that doesn’t go away. Newborns normally have irregular breathing, so you need to count for a full minute. There should be no pauses longer than about 10 seconds between breaths.

Pulling in of the ribs when taking a breath (retraction)

Wheezing, grunting, or whistling sounds while breathing

Odor, drainage, or bleeding from the umbilical cord

Worsening yellowing (jaundice) of the skin on the chest, arms, or legs, or whites of the eyes

Crying or irritability which does not get better with cuddling and comfort

A sleepy baby who cannot be awakened enough to nurse or bottle feed

Signs of sickness (for example, cough, diarrhea, pale skin color)

Poor appetite or weak sucking ability

Vomiting, especially when it is yellow or green in color

Every child is different. Trust your knowledge of your child and call your child's healthcare provider if you see signs that are worrisome to you.

Fever and children

Always use a digital thermometer to check your child’s temperature. Never use a mercury thermometer. For infants and toddlers, be sure to use a rectal thermometer correctly. A rectal thermometer may accidentally poke a hole in (perforate) the rectum. It may also pass on germs from the stool. Always follow the product maker’s directions for proper use. If you don’t feel comfortable taking a rectal temperature, use another method. When you talk to your child’s healthcare provider, tell him or her which method you used to take your child’s temperature. Here are guidelines for fever temperature. Ear temperatures aren’t accurate before 6 months of age. Don’t take an oral temperature until your child is at least 4 years old.

Infant under 3 months old:

Ask your child’s healthcare provider how you should take the temperature.

Rectal or forehead (temporal artery) temperature of 100.4°F (38°C) or higher or less than 97.5°F (36.5°C), or as directed by the provider

Armpit temperature of 99°F (37.2°C) or higher, or as directed by the provider